Divine Providence Health Center Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

331605 Issued in MN

Legal business name

DIVINE PROVIDENCE HEALTH CENTER INC

Doing business as

Divine Providence Health Center

Practice address

312 East George Street
Ivanhoe, MN 56142-0136

Phone

(507) 694-1414

Fax

(507) 694-1191

NPI assigned

Jul 11, 2006

Last updated

Jul 21, 2022By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mary Elizabeth Swanson, LNHA

Title

Administrator

Phone

(507) 694-2010

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Divine Providence Health Center Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1326072406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 EAST GEORGE STREET",
            "city": "IVANHOE",
            "state": "MN",
            "postal_code": "561420136",
            "telephone_number": "507-694-1414",
            "fax_number": "507-694-1191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 EAST GEORGE STREET",
            "city": "IVANHOE",
            "state": "MN",
            "postal_code": "561420136",
            "telephone_number": "507-694-1414",
            "fax_number": "507-694-1191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE PROVIDENCE HEALTH CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-11",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "SWANSON",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "507-694-2010",
        "authorized_official_credential": "LNHA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MN",
            "license": "331605",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "859245400",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Divine Providence Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Avera Tyler (Avera Medical Group Ivanhoe)
• Dawn R Bucher, CNP
• City of Ivanhoe (Ivanhoe Ambulance)
• Ashley Darlene Conner
• Divine Providence Health Center
• Divine Providence Heatlh Center
• Divine Providence Heatlh Center Inc.
• Divine Providence Medical Clinic
• Emily Anne Giese, COTA
• Heidi Ann Hansen, APRN, CNP

• Skilled Nursing Facility in Ivanhoe, MN
• Providers in Ivanhoe, MN by specialty
• Skilled Nursing Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.